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,oP4 .coG SAN JOAQUIN COUN'
<br /> �+ ENVIRONMENTAL HEALTH DEPARTMENT
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<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> • �q.. .�;;P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd
<br /> �iFOR
<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: w UM eA) S #` Date: I
<br /> Address: C- City' S Tun zip Code: ZG,Z
<br /> Owner/Operator: - 1�•S �p �u 1; �. Telephone:9 _ n
<br /> Program Element;, �Z Program Record: R k." InspectionType:
<br /> B180 Posted Yes e No Permit Posted Yes No Re-Inspection on or After:
<br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance
<br /> See reverse side for code sections and general requirements that correspond to each violation listed below.
<br /> Ma'or violations ose a threat to Eublic health and must be corrected immediatel . Non-corn fiance may warrant closure of the food ity
<br /> 7N n:o VA Demonstration of Knowledge 7, our T cos Supervision ...Our.
<br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties
<br /> Employee Health and Hygiene Personal Cleanliness
<br /> . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints
<br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements
<br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used
<br /> i
<br /> 1 Jr?tapu �,TM 7. Food protected from contamination during storage
<br /> 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use
<br /> . Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used
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<br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled
<br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided
<br /> Proper cooling methods 32. Food properly labeled and honestly presented
<br /> 10. Proper cooking time and temperatures Equipmj! C Ytensils i Line,41 �`
<br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br /> Protection From Contarriination7 _, 34. Warewashing facilities maintained;test strips available
<br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair
<br /> i A- 1 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use
<br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained
<br /> Source 38. Approved and sufficient ventilation and lighting
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<br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible
<br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths
<br /> 17. Compliance with Gulf oyster regulations R21 ,
<br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention
<br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed
<br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained
<br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing
<br /> Highly Susceptible Populations Permariept _ Ctl
<br /> 1 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean
<br /> Water/Hot Water. 46. No living or sleeping quarters inside facility
<br /> 1.Hot and cold potable water available. COmpliahce and Enforcement�_.
<br /> _ Liquid Waste Disposal `
<br /> 7. Signs posted;last inspection report available '
<br /> 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements
<br /> Vermin 49. Facility operating with a valid health permit
<br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment
<br /> 51. Permit Suspension
<br /> Received By(ritle:
<br /> EH Specialist: Phone: Page 1 of
<br /> EHD 16.23 (1st pg) 4/9/12 FOOD PROGRAM OIR
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